Advocating for Stellate Ganglion Block (SGB) Coverage
18th Jan 2023
The Chicago Police Department (CPD) and the City Council are exploring alternative treatments for post-traumatic stress disorder (PTSD), including Stella’s innovative treatment, the Stellate Ganglion Block (SGB), or, as some officers refer to it, the “God shot.”
Chicago’s police force is facing a mental health crisis, with six officers dying from suicide in 2022. Not only does their job take a toll on their mental health, but the loss of partners to suicide leads to debilitating secondary trauma.
Secondary trauma, also known as vicarious trauma or compassion fatigue, is the emotional and psychological strain that can result from exposure to the traumatic experiences of others, either through direct interactions or indirect interactions.
Stella’s Chief Medical Officer, Dr. Eugene Lipov, who has been a leader in the battle against post-traumatic stress for the last two decades, aims to reset the system to its pre-trauma state for those in need, first responders, veterans, and civilians.
Several CPD officers, including Commander Melinda Linas, have received it to combat trauma’s effects. Linas stated that the treatment “made me a better person, it made me a better mother, it made me a better wife, it made me a better police officer.”
However, though the FDA approves the SGB for use as a pain management treatment and local anesthetics like bupivacaine and ropivacaine, the SGB is not yet FDA-approved for the treatment of PTSD and costs $1,500-$2,000 per shot. The phrase “not FDA-approved” can raise questions, but as Stella Chief Psychologist Dr. Shauna Springer explains it on Anxiety.org,
“SGB has been applied to symptoms of trauma in the same way that aspirin is used to reduce risk of heart attack. Aspirin is also “not FDA-approved” for use in this way – like SGB, it was also primarily developed to treat pain, but has shown clear promise.”
Aldermen advocated for the shot to be covered by officers’ health insurance, flex spending plans, or grants funded by the City Council. Despite the high cost and lack of formal approval, CPD officers who have received the treatment have reported significant improvements in their lives.
Biological interventions for mental health care, including the SGB and Ketamine Infusion Therapy, are currently not covered by insurance. Stella offers assessments and follow-up appointments that may be eligible for insurance reimbursement, although the actual amount reimbursed may vary based on insurance coverage and deductible.
To make treatment more affordable, Stella accepts payment through Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs), and major credit cards, as well as offering interest-free financing plans through CareCredit for up to six months to qualifying patients.
We are committed to providing the best care for individuals dealing with symptoms of post-traumatic stress, anxiety, and depression.
Our team of trauma-informed Psychiatric Mental Health Nurse Practitioners will conduct a thorough assessment of your symptoms and health history to create a personalized treatment plan. Our comprehensive care plans include innovative biological interventions like the Stellate Ganglion Block (SGB) and ketamine Infusion Therapy, as well as regular follow-ups over a six-month period to ensure that our patients achieve their desired outcomes.
If you are interested in learning more about our services, please don’t hesitate to reach out to one of our Care Advocates at 412-455-8813 to schedule an initial assessment.
Whether we’re browsing the internet for solutions or have successfully found one, we often still have many questions surrounding the type of treatment we’re pursuing up until the day of and sometimes even after the treatment has taken place. Generally, we know who will perform the treatment, how long it takes, and what we’re supposed to feel after. However, we may rarely dive deep into the science behind it or understand how, or why, it works.
As Stella continues to grow around the world, it’s important for us to give you easy access to the information you need to find a solution.
What is SGB?
First, it’s essential to know about the stellate ganglion nerve. The stellate ganglion is a conglomerate of sympathetic nerves located on both sides of the neck. After experiencing a traumatic event or as a result of ongoing stressors, the brain’s fight-or-flight response turns on and sometimes stays on long after.
When the fight or flight response is turned on extensively, it can lead to extra nerve growth in the brain. This, in turn, leads to an increase in norepinephrine.
Norepinephrine: also called noradrenaline, is a substance that is released predominantly from the ends of sympathetic nerve fibers that acts to increase the force of skeletal muscle contraction and the rate and force of contraction of the heart. The actions of norepinephrine are vital to the fight-or-flight response, whereby the body prepares to react to or retreat from an acute threat.1
Norepinephrine has been demonstrated in patients with post traumatic stress, and leads to symptoms of post traumatic stress. Increases in norepinephrine leads to hypervigilance, anxiety, and other symptoms of post traumatic stress.
As you may notice, these biological responses are often associated with symptoms of post traumatic stress, depression and anxiety. We’ll discuss how SGB impacts the stellate ganglion nerve and norepinephrine next.
How Does SGB Work?
SGB is often used to relieve pain, and recently, new indications for SGB have become known. These include hot flashes during menopause and others, including the latest, the treatment of post traumatic stress.
SGB is a guided anesthetic injection performed for the purpose of anesthetizing the stellate ganglia. Treatment begins with a double injection on the right side of the neck, and further treatment may include the left side. The impact of a local anesthetic on the stellate ganglia is as follows:
Can provide relief in under 10 minutes.
Eliminates extra nerve growth of fight or flight nerves that occurred after the trauma which can lead to prolonged relief of symptoms of post traumatic stress.
Reduces norepinephrine which leads to the deactivation of the amygdala, the fear center.
The anesthetic used in this treatment is ropivacaine or bupivacaine. Bupivacaine is a medication that has been approved by the FDA since 1972 for use as a local anesthetic and is leveraged within many common treatments, like epidurals during child birth.
The Mayo Clinic describes bupivacaine as a local anesthetic injection used to numb an area of the body during or after surgery or other procedures, childbirth, or dental work. They describe ropivaince as an injection that is used to cause numbness or loss of feeling before and during surgery or labor and delivery and used to relieve acute pain.
Advanced brain scans demonstrate that the amygdala is over activated in PTS. This reversal of this over-activation can be demonstrated using SGB by using advanced brain scanners.
While more research still needs to be done, this may be why SGB can help relieve pain, is able to reduce symptoms of emotional trauma and mental health challenges, and reset your mind to its pre-trauma state. Essentially it reverses that culmination of events that led to the symptoms we’re experiencing.
What is SGB for PTSD?
In the field of psychology, Post-Traumatic Stress Disorder (PTSD) is defined as a response to experiencing traumatic or stressful event(s) that creates feelings of horror or helplessness. Symptoms of PTSD can include irritation, anxiety, depression, flashbacks, loss of interest in things once enjoyed, etc.
Since it was discovered that SGB can effectively and quickly reduce these symptoms of PTSD, the research into PTSD and the treatment modalities used to combat it have greatly expanded. Now, even brain imagery data suggests that changes from PTSD are visible, namely the nerve growth around the amygdala and that a simple injection of local anesthetic can reset the brain back to its pre-trauma state – showing some evidence that post-traumatic stress disorder is actually a treatable injury rather than a disorder.
SGB for PTSD isn’t always the first approach when looking for the right treatment. But since it started being used to treat PTSD, it boasts over an 80% success rate for individuals experiencing emotional trauma and mental health challenges. Those living with PTSD often say that the SGB treatment helped them feel calm again in their own bodies and helped their sleep, anxiety, and depression, among other symptoms.
What is Stella’s approach?
Stella approaches PTSD as an injury, often referring to it as post-traumatic stress injury or PTSI. This helps destigmatize the term PTSD. Knowing PTSD is an injury and can be healed helps us find the solutions we need to heal, like SGB.
Stella offers a modified SGB for PTSD called the Dual Sympathetic Reset (DSR). Using image-guided techniques, a highly trained Stella doctor injects a local anesthetic into two separate bundles of nerves found near the base of the neck.
While other SGB providers typically only do one injection into one nerve bundle, Stella performs a double block, which is why we call it a dual reset. When we add another ganglion – the superior cervical ganglia, the effects of treatment are significantly improved.
Stella’s Dual Sympathetic Reset is two injections, either at C3 and C6 when using fluoroscopy or C4 and C6 when using ultrasound, which generally affects all the ganglia within the neck due to the close proximity. The entire process is completed in under 20 minutes.
How To Learn More
Find you if you may be experiencing symptoms of depression, anxiety or post traumatic stress by taking Stella’s symptoms quiz.
You can even hear first hand experiences and personal testimonials directly from Stella’s patients on our YouTube channel, including the story of own Chief Medical Officer and SGB pioneer, Dr. Eugene Lipov.
Is SGB Right For You?
Call our Care Advocates at 1-412-455-8813 to schedule your initial consultation with a Psychiatric Mental Health Nurse Practitioner. You’ll work together to determine if SGB is the next right step in your healing journey.
Most Commonly Asked Questions about Stellate Ganglion Block (SGB)
12th Dec 2022
If you’ve experienced symptoms of emotional trauma and mental health challenges, you’ve most likely researched the different types of treatments available for relief, like talk therapy and medication – two of the most common types of treatment. So naturally, we gravitate toward these treatments as they are currently the most well-known and covered by most insurance companies.
We may be skeptical at first when we encounter new types of innovative treatments. While a whole network of innovative and minimally invasive procedures can offer relief sometimes in an instant, they aren’t the first line of defense for treatment recommendations.
Innovative treatments like the Stellate Ganglion Block (SGB) have been around for decades, even centuries, but many are just finding out about it now.
Stella’s Stellate Ganglion Block (SGB), known as the Dual Sympathetic Reset, has made waves in mental health care and has challenged the traditional care path model as a safe and efficient way to relieve symptoms like depression, anxiety, and PTSD. It can help relieve years, and even decades, of debilitating symptoms. As this life-saving treatment gains awareness, education is a crucial step in addressing the questions and concerns of those looking for the right care.
This article covers the 15 most commonly asked questions about the Stellate Ganglion Block (SGB):
Is SGB proven to work?
At Stella, we believe in the transparency of treatment outcomes. While no medical procedure is guaranteed to work for everyone, the Stellate Ganglion Block (SGB) by Stella has helped thousands of patients find lasting relief from their trauma-related symptoms.
The PTSD Checklist (PCL) is a self-report survey used to measure PTSD symptoms. According to the National Center for PTSD Guidance, a 10-point decrease in PCL score is a clinically significant improvement. In a study of 327 Stella patients who received SGB between December 2016 and February 2020, on average, over 83% reported a 28.9-point decrease in their PCL score. These Stella patients experienced a result that’s almost three times better than that of other treatments.
How long do the positive effects of SGB last?
Over 83% of Stella patients experience lasting relief from their trauma symptoms after one dual injection.
The duration of the Stellate Ganglion Block’s (SGB’s) positive effects varies from patient to patient, lasting months or years.
While the longevity of SGB’s effectiveness is still being researched, in a 2014 study, 70% of participants were clinical successes at a follow-up administered between 3 and 6 months after treatment.
Will SGB erase my memory or impair my survival instinct?
The Stellate Ganglion Block (SGB) does not erase your memory, but after treatment, you may find that your memory is clearer.
SGB does not compromise your survival instinct because it does not “turn off” your fight-or-flight response. When your fight-or-flight response is stuck in an overactive state, your body is constantly experiencing a high level of stress which can be due to an imaginary threat. For example, it can feel like you’re being chased by an imaginary bear, for example. SGB does not take your ability to run away from the bear. Instead, it removes the imaginary bear. Should a real bear appear, you will still instinctually run away from it.
How is SGB by Stella different from SGB from other providers?
Widely considered the pioneer of the Stellate Ganglion Block (SGB) for PTSD, Dr. Eugene Lipov, Stella’s Chief Medical Officer, is a Board Certified anesthesiologist and pain management physician. More than fifteen years ago, he initialed his SGB protocol that has the ability to “reset” the fight-or-flight response, returning it to its pre-trauma state.
SGB was originally developed as a single injection.
After researching and testing many ways of administering SGB for PTSD treatment, Dr. Lipov found that two injections – known as the “Dual Sympathetic Reset” – yield the best results. The injections are given back to back.
Each Stella doctor is Board Certified and is personally trained by Dr. Lipov in Stella’s proprietary SGB methodology. We also require that our doctors use image guidance for correct needle placement.
SGB by Stella
The “Dual Sympathetic Reset”
Board Certified medical doctor
Naturopathic practitioner, CRNA, Board Certified medical doctor
Trained by Dr. Eugene Lipov?
Side of Neck
Right. Left for right-sided non-responders.
C6 and C4 (or C3)
Local and Twilight Sedation (optional)
40+ Treatment Centers nationwide
Provided to those who qualify
Has SGB been clinically studied?
Yes, there are numerous clinical studies about Stellate Ganglion Block (SGB).
This study explores the effectiveness of single and dual injection SGB. While both methods are effective, the study proposes that dual injection SGB – the same approach Stella uses – may be more effective than a single injection SGB in the treatment of PTSD.
This multisite, randomized clinical trial of SGB outcomes on PTSD symptoms, reports an improvement in the PTSD symptoms of active-duty service members after two SGB procedures. On average, the group treated with SGB experienced a 12.6-point decrease in their Clinician-Administered PTSD Scale (CAPS-5) score, and the control group experienced a 6.1-point decrease in their CAPS-5 score.
This review of recent and historical SGB literature finds evidence of substantial beneficial psychiatric effects that supports the use of SGB as a PTSD treatment that may provide positive results and reduce barriers to therapy, particularly among military populations.
How does SGB work with other types of treatments (like talk therapy)?
The Stellate Ganglion Block (SGB) can work well in combination with other treatments. After SGB, many Stella patients feel a new sense of calm that can accelerate the positive impact of existing therapies (e.g., talk therapy, EMDR, CBT, DBT, etc.). For example, patients may find that they can recall their past and discuss it with their mental health provider without feeling as though they’re reliving it.
If you already have a mental health provider, we suggest that you continue working with them after SGB to further your healing. If you do not have a mental health care provider, Stella may be able to refer you to one.
What’s included with Treatment by Stella?
Treatment by Stella is a commitment to your recovery, from first contact to the moment you feel like yourself again. The Stella Standard of Care was created to meet your needs before, during, and after treatment. This is the new model of trauma treatment.
Getting To Know You:
The first step is to speak with a licensed Psychiatric Mental Health Nurse Practitioner (PMHNP). The PMHNP will conduct a bio-psycho-social assessment, including a review of your symptoms and health history. The PMHNP will create a custom treatment recommendation for you using this information.
Our PMHPs use validated measures to gauge your symptoms. These measures include the Post-traumatic Stress Disorder Checklist (PCL-5) for symptoms of PTSD/ emotional trauma, the Generalized Anxiety Disorder-7 (GAD-7) for anxiety, the Patient Health Questionnaire-9 (PHQ-9) for depression, and the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) for traumatic brain injury.
Throughout the journey, you will work with a dedicated Patient Care Coordinator who will coordinate your care and help answer any questions along the way.
If receiving the Stellate Ganglion Block (SGB), the entire procedure takes less than 20 minutes, but please plan on being at the facility for one to two hours. The positive effects of SGB are often immediate.
If receiving ketamine, each treatment typically takes 45 minutes. Please plan on being at the facility for one to two hours. Most have relief from symptoms within hours of treatment.
Those on Care Plans will work with Stella’s PMHNPs over six months and receive an individualized treatment plan that combines biological and psychological interventions to provide the best outcomes possible.
Following treatment, your PMHNP will call to review the procedure’s effectiveness and ask about any symptoms you may be experiencing. Each patient will also have a 30-minute follow-up to continue that review and discuss how to maximize the positive effects of treatment. PMHNPs are there to physically, mentally, and emotionally support a patient, as uniquely required, during this session.
Those on Care Plans will have additional follow-up sessions with Stella’s PMHNPs which include completing standard mental health assessments, determining whether additional treatment is warranted, and discussing trauma-informed, healing-related topics such as getting better sleep, approaching grief, or mindfulness techniques.
Stella is here for you
Fast and effective care for symptoms of emotional trauma and mental health challenges is at our front door, and we have already helped thousands of people in need. The more questions asked and the more information given can help lead innovative treatments like SGB and mental health companies like Stella into the lives of people in need. We’re dedicated to you and innovative treatments because the possibilities are endless.
If you are interested in learning more, please contact our Care Advocate team directly by calling 1-412-455-8813.
After the 20-minute Stellate Ganglion Block (SGB) treatment, Adam’s life changed.
Adam, whose real name was changed for privacy reasons, suffered from mental health challenges for years created by consistent, repeated traumas throughout his life.
Finding the right treatment was a long journey, but SGB’s impact was quick.
“I no longer have continual pressure in my head, defensive in difficult conversations and arguments, impatient with people or situations, or have negative thoughts. It’s like a huge dark cloud was lifted from me.”
Treatments like SGB, talk therapy, electroconvulsive therapy, and prescription medications can lead to excellent results for people battling mental health challenges. Even though these treatments can bring rapid relief from trauma symptoms, they don’t mark the end of the road to recovery.
For many people, there’s still work to do after a major breakthrough. Continued mental health care after treatment allows us to live the most fulfilling life possible.
Life after treatment
Recovery mode refers to the changes someone notes in their mind and body after treatment. Recovery mode can include a surge of emotions, new thoughts and fresh perspectives, and physical differences.
Recovery mode is our mind and body’s way of laying out the best steps forward for a beneficial recovery.
Let’s explore how recovery mode presents itself, the immediate actions to take, and how to promote healing for years to come.
What to expect during a healing journey
It’s common for people living with debilitating symptoms to suppress their emotions without realizing it. After they experience a successful treatment outcome, they’re likely to experience a flood of unfamiliar emotions.
These thoughts and feelings can be confusing and overwhelming. However, this is a normal reaction to many different treatments.
Emotional Acuity: The ability to recognize and correctly identify one’s own emotions, critical to navigating new thoughts and feelings.
To get in touch with these emotions and really explore them, we suggest asking the following questions:
Is it something I’ve felt before?
What words can I use to articulate this?
Am I experiencing a single emotion or a combination of emotions?
Assessing and understanding emotions is the first step to navigating them.
Gaining new perspectives
Many people have a new perception of themselves during a healing journey or after successful treatment. This perception can impact daily life, employment, and/or relationships.
It can take time to fully allow your emotions to shift into what feels like healthy ‘new normals.’
Make sure to validate the truth behind what is being experienced, like when you experience happiness or sadness, it’s not wrong to feel that way. Don’t try to change or recreate the truth. Instead, remember that perceptions, feelings, and emotions come and go.
Mental health challenges can take a toll on the body. Unfortunately, we can get so used to feeling one way for years or decades before treatment that we often forget to check in on our physical well-being, like when the stress we hold in our muscles tenses up and leads to pain and soreness.
Whether or not our body is having a good or bad day, take the time to check in and do a full body scan. Ask questions about our posture, take deep breaths, and think about the best way to get our mind and body through the day.
Though these life adjustments may seem minor, checking in on ourselves is a habit worth forming. Helping our bodies and minds adjust to the relief from symptoms can normalize these new experiences and create new baselines for our mental and physical health.
Take steps toward continued care
Regardless of what one’s healing journey looks like, it’s important to remember that no one has to go it alone.
Regardless of whether someone has a support system of friends, family, and/or colleagues, mental health care providers are always willing to help. Here are five key steps:
Talk to a mental health care provider
A typical step in a healing journey is working with mental health professionals like psychologists, counselors, clinicians, therapists, clinical social workers, psychiatrists, or psychiatric mental health nurse practitioners.
Once the right fit is found, these professionals can help us better understand the thoughts, feelings, and actions we may experience while feeling the impact of symptoms. They also teach how to adjust thought processes, give the right resources, and recognize the best paths on a healing journey.
Awareness around stressors
Stress can exacerbate mental health challenges. For example, it can heighten symptoms like anxiety and depression and hinder one’s ability to get a good night’s sleep. It can also lead to physical pain, like headaches and muscle tightness.
According to The National Alliance on Mental Illness, “When experiencing long-term stress, your brain is exposed to increased hormone levels called cortisol. This exposure weakens your immune system, making it easier for you to get sick.”
Mindfulness habits and physical health
Exercise and eating well are good ways to reduce stress throughout the day. In return, these can promote better sleep and balance in the mind. Ask a doctor or nutritionist for healthy food suggestions.
Meditation has great benefits for ongoing care, especially during an emotional release. Meditation helps us gain new perspectives on our past experiences. It promotes a focus on the present and allows us to approach the day with a calm and collected mindset.
Assess old, new, and future habits and relationships
In creating a new normal, we may realize that certain situations, behaviors, and relationships are no longer healthy for us. In some cases, it is important to consider whether continuing to engage in them is helpful to our growth.
It can be hard to break away from activities or relationships that may have been part of our lives for a long time. But it can be a necessary step.
Try out old hobbies and explore new ones
Explore new hobbies or activities once enjoyed. For years, our minds may have tricked us and said that the activities we enjoyed weren’t as positive as we thought.
The truth is that joy and positive experiences are just as powerful and valuable as any other feeling. When we experience an emotional release of joy, follow the instinct, especially if it comes at a time of sadness. Like many emotions, sadness and joy can happen at the same time.
Revisiting old hobbies opens channels for escape, an exploration into our feelings, distraction, and a wellness reset. Hobbies can be somewhat therapeutic and can change our perception of ourselves, our loved ones, and those we interact with daily. Old or new, exploring passions and hobbies can help our recovery process.
Start your healing journey
Stella is here for you. We offer industry-leading biological interventions for symptoms of post-traumatic stress, anxiety, and depression.
Our care plans begin with an assessment by a trauma-informed Psychiatric Mental Health Nurse Practitioner who will review an individual’s symptoms and health history to create a custom recommendation. Our wrap-around care plans include cutting-edge biological interventions – like SGB and/or Ketamine Infusion Therapy – plus regular follow-ups over a six-month period to ensure that our patients achieve their desired outcomes.
Call a Care Advocate at (908) 928-4086 to schedule an initial assessment.
This observationalstudy will examine the psychological and physiological effects of the Stellate Ganglion Block (SGB) procedure and seek to measure to what extent the SGB treatment reduces trauma-related symptoms and improves overall biometric health outcomes.
Tracking SGB Results Through Biometrics
Participants will wear a WHOOP wearable band for 8 weeks to calibrate and measure changes in physiological response to Stella’s SGB treatment protocol, called the Dual Sympathetic Reset. This protocol, developed by Dr. Eugene Lipov, involves two injections into a group of nerves on one side of the neck compared to many other providers who only do a single injection into one nerve bundle.
The WHOOP band will continuously measure sleep quality, heart-rate variability, and resting heart-rate, among other biometric indicators.
All participants will receive a free WHOOP strap and 6-month membership, and receive a $250 rebate from Stella on the cost of their treatment. Throughout the study, participants will be asked questions about their mental health and stress symptoms while the WHOOP strap monitors sleep and heart rate.
Why This Matters
Participants will be contributing to important research with the potential to expand the universe of access to SGB treatment for trauma/PTSD.
Studies like this help further evidence that integrates psychological outcomes and biometric health data to better understand the degree to which SGB treatment impacts sleep and trauma-related symptoms.
To find out if you qualify for the study, call us at 908-928-4086.
Preventing, Understanding and Discussing Death by Suicide
06th Sep 2022
Over the pasts few decades, awareness of suicide prevention in the United States has expanded. Independent volunteer prevention programs like the American Foundation for Suicide Prevention, various counseling programs, and government programs on the local, state, and federal levels like the new 988 Suicide and Crisis Lifeline have all taken shape to help those in need. While these programs have saved countless lives, it is hard to know someone that hasn’t been affected by suicide whether it be family, friends or coworkers. A recent Stella employee survey revealed that just over 51 percent of it’s employees have lost a loved one to suicide.
Though awareness surrounding suicide has become more prevalent, it is still a leading cause of death in the US. According to the Centers for Disease Control, “Suicide is a leading cause of death in the United States with 45,979 deaths in 2020.” Suicide rates saw an increase of 30 percent between the years 2000–2018. The rate decreased in the years 2019–2020 but still remains on the list of highest mortality rates in the country.
Who is affected the most by suicide and suicide attempts?
While all different types of people are affected by suicide and suicide attempts, some groups are more at risk than others. According to the Substance Abuse and Mental Health Services Administration, or SAMHSA, the groups most affected by suicide are:
Middle-Aged People and Older Men
Upwards of 80 percent of all suicides in the U.S. are among middle-aged men and women, 45-54. Men 85 and older have the highest suicide rate in the country due to possible isolation, a history of violence, and more.
Young American Indian men face a greater risk of suicide and suicidal ideations due to isolation, historical trauma, poverty caused by systemic issues, cultural stress, and more. American Indian men in the Northern Plains seem to face the greatest risk.
Alaska currently holds one of the highest suicide rates in all fifty states. Young Alaskan men are especially at risk due to substance abuse and isolation.
Two other very important groups affected by higher percentages of suicide listed by SAMHSA are veterans and members of the LGBTQ+ communities.
According to the 2021 National Veteran Suicide Prevention Annual Report, over 6,000 veterans took their own lives in 2019. That’s around 14 percent of the 45,000 plus people that committed suicide that year. “Veterans ages 55-74 were the largest population subgroup,” the VA reported. “They accounted for 38.6% of Veteran suicide deaths in 2019.” Many veterans suffer from post-traumatic stress injury that can further lead to debilitating mental health conditions.
The LGBTQ plus community faces an insurmountable challenge with homophobia, hatred, and acceptance from outside parties. This can lead to suicidal ideations and suicide attempts for those receiving the hatred. The CDC says, “Gay, bisexual, and other men who have sex with men are at even greater risk for suicide attempts, especially before the age of 25.” LGBTQ plus youth have an even higher risk of suicidal ideations and attempts due to their unsafe environments.
Suicide and trauma
Symptoms of trauma and post-traumatic stress injury can often run hand in hand with suicidal ideations or attempts. There is evidence that trauma, particularly brought on by sexual abuse in childhood and veterans that have seen combat, does “increase the risk of suicidal thoughts,” according to the U.S. Department of Veterans Affair. “In this research, combat trauma survivors who were wounded more than once or put in the hospital for a wound had the highest suicide risk.” Veterans can carry the weight of combat long after they’ve returned home from war. The guilt often leads to suicidal ideations. More studies continue to explain that those with PTSI, or PTSD, have higher suicide ideations or attempts – Partly, due to the lack of preventions or ability to express emotions in a safe environment.
Treatment of suicidal ideations and attempts
Around five people die by suicide in one hour in the United States, that’s one person every 11 minutes, and the number of those that thought about suicide is even higher, 12.1 million people seriously considered taking their life, and just over three million planned an attempt, and 1.2 million attempted taking their life. The emotional and physical impact of suicide or suicide attempt is astronomical on their loved ones. It can lead to post-traumatic stress injury, depression, anxiety, and other mental health conditions. Suicide and suicide attempts can also make a large impact financially. “In 2019, suicide and nonfatal self-harm cost the nation nearly $490 billion in medical costs, work loss costs, the value of statistical life, and quality of life costs,” the CDC reported last year.
There are various modalities used to combat suicidal ideations. And though, there is no one size fits all approach to solving suicidal ideations, some of the most popular avenues are cognative behavioral therapies that reduce the ideations through patients actively working on coping mechanisms, Antidepressants, antipsychotic medications, anti-anxiety medications that can help reduce symptoms, and support from loved ones.
Over the last couple of decades, new treatments like the stellate ganglion block (SGB) and ketamine have given hope to many with suicidal ideations. SGB is an injection of local anesthetic into the stellate ganglion that helps restore normal biological function. Some evidence has shown that it can efficiently reduce symptoms of trauma, like hypervigilance, trouble sleeping, and anxiety, that can lead to suicidal ideations.
One person that received SGB treatment by Stella said, “None of the memories have disappeared but I no longer feel them or relive them every second of every day. I was at a point where I couldn’t stop feeling suicidal, it was absolute torture to even imagine having to live another day stuck in my own head. I no longer feel suicidal.”
According to a study byThe BMJ, ketamine has a rapid relief effect on those suffering from depression and severe suicidal ideations. More patients involved in the study reached a full remission of suicidal thoughts within three days time compared to those with a placebo. Like SGB, ketamine is not a cure, but a big step forward on the path to recovery.
How is Stella handling suicide prevention?
Stella’s number one priority is to help those in need suffering from certain mental heatlh conditions – Conditions that can often lead to symptoms like suicidal ideations or even attempts. The tireless advocates, care coordinators, and medical professionals work daily to ensure opportunities for healing like the stellate ganglion block and ketamine treatments are available to those in need.
Like a lot of mental health companies, Stella has actively opened up a conversation about mental health, combating the stigmas surrounding those suffering. The more open people are, the more resources become available to those that may not know where to search. The Stella blog has opened up a dialogue about the signs and symptoms of trauma, depression, anxiety, and more. The Story of Our Trauma podcast offers insight from those experiencing similar situations, like Ron Self, a veteran affected by a suicide attempt. And our testimonial page has shared personal stories of successful solutions to those combating symptoms.
What else is being done to prevent suicide and suicide attempts?
More than 90 percent of people who survive an attempted suicide never go on to die by suicide, according to the CDC. But 90 percent is still far too many people. Recent large-scale programs from the federal government have been initiated, like the 988 Suicide and Crisis Lifeline, to help with suicidal ideations that can lead to suicide attempts.
The 988 Lifeline
The 988 Suicide and Crisis Lifeline provides 24/7 suicide prevention counselors from over 160 centers in the United States. The Biden Administration increased federal funding from $24 million to $432 million to include resources for select groups of people like the ones mentioned in the previous section. It is available and open to anyone that is in emotional distress or facing suicidal ideations.
American Foundation for Suicide Prevention
The American Foundation for Suicide Prevention is a volunteer organization that has been around since 1987 and has remained a valuable resource for those looking for help with suicidal ideations. The organization actively funds research and education surrounding suicide, advocates for policies at a federal level, and supports those that have been impacted by the suicide of a loved one.
Suicide remains a leading cause of death in this country, but with awareness and active dialogue, we can lower the number of those with ideations, plans and those that take their own life. The resources are available, and if you or a loved one is suffering from suicidal ideations, please connect with the 988 Lifeline.
Groundbreaking Clinical Study on SGB is in the Works
19th Aug 2022
Stella’s mission from day one is to alleviate symptoms of post-traumatic stress disorder (PTSD) with innovative solutions like the Stellate Ganglion Block (SGB). We’ve helped and will continue to help, thousands of people find lasting relief from trauma symptoms of all kinds. As conversations around trauma continue to grow, so must SGB awareness.
A Big Jump Forward
Stella is excited to hear that a research study from NYU Langone Health will clinically test the efficacy of SGB on PTSD. This study aims to illustrate that SGB can efficiently reduce PTSD symptoms.
A Future of Healing
Studies like these help raise the much-needed awareness surrounding PTSD and usher in effective and innovative pathways to care. If you want to learn more or are interested in participating, please click below.
In this blog post, we’ll walk you through Treatment by Stella so you know what to expect before, during, and after SGB.
Qualifying for SGB
We will never ask you to tell your story or justify your trauma to qualify for treatment.
Treatment by Stella is based on the severity of each person’s symptoms of depression, anxiety, and emotional trauma. It’s common for trauma survivors to feel unworthy of receiving care, these algorithmic-based tests help validate one’s experiences due to their unbiased nature.
For those who qualify for treatment, the journey to relief begins.
For many of our patients, waiting to receive SGB is more difficult than the actual procedure.
Stella isn’t always the first stop on our patients’ healing journeys. It’s common for trauma survivors to try multiple treatments – like prescription medications, talk therapy, or deep breathing exercises. While every time-tested, research-backed treatment has its merits, none of them can guarantee 100 percent relief. When a treatment doesn’t work, it can feel personal. And that may cause us to lose trust in the healthcare system.
It’s completely normal to be skeptical or feel hopeless about the possibility of feeling good again. Memories of failed treatments can trigger anxiety and hesitation about SGB and worrying can keep us up at night. Our days may be interrupted by intrusive thoughts like:
What if SGB doesn’t work? What if I can’t get my heart rate down? What if my vitamins actually had turmeric in them? I stopped taking my blood thinners, right? I can’t wait any longer to feel better. Will SGB change who I am?
Here are four ways to help ease your mind and cope with this type of thinking before treatment.
Some feel nervous talking to their friends, family, and care providers following SGB as they navigate the changes in their bodies in real-time. Some feel “pressure” to show positive results so they don’t let their loved ones down. These are common reactions and may even be tied to trauma responses.
Setting expectations with our support circle beforehand can help alleviate these types of reactions after treatment.
Ask for some “quiet time” to yourself immediately after treatment to allow yourself to “unplug” and focus on resting.
Explain that you will share a quick update immediately after your SGB procedure followed by more details the next day.
Set boundaries for what types of language you want your support system to use. Many prefer to be asked “How are you feeling right now?” instead of triggering language like “Did it work?”
Once treatment is scheduled, Stella will send you an email with the information you need to prepare for treatment, including:
The location (address, pictures of the facility, parking details, how to check in, etc.)
Your doctor (their name, picture, medical training, current Board Certifications, etc.)
The procedure (what to wear, type of image-guidance used, companion policies, etc.)
Talk to your mental health care provider:
Many trauma-informed therapists are familiar with SGB, and we recommend discussing your upcoming treatment plan with them. If you do not have a mental healthcare provider, we may be able to refer you to one in our network.
Talk to the Stella team:
If nervousness or anxiety arises on treatment day, please know that you’re in a safe space and you can openly ask questions or communicate your worries to the team on site. Ask your Stella doctor to walk you through the treatment again, step by step.
Following your treatment
Whether one chooses to stay awake or use twilight sedation, many people experience similar outcomes immediately after treatment. Here are a few of the most common responses:
Sudden urge to cry
Most people report a rush of emotions. We recommend letting out the emotions. This is extremely common and healthy. Your Stella MD partner is familiar with this response and will respect your time and space through this release.
While most have difficulty articulating what “calmness” feels like, they know it’s the feeling they are experiencing. We’ll touch on this more shortly.
SGB can make people feel like a weight has been lifted off their chest or shoulders. This may make them feel like they can breathe more deeply and in turn feel more rested and relaxed than they’re used to.
It’s normal to feel tired after a medical procedure. We recommend that our patients take a long nap after they leave get home. Sleep allows the body to heal and feel calm. Many patients find it helpful to turn off their cell phones while resting.
The Following Days
Be patient with yourself in the days following treatment and revisit the expectations you set for yourself and your loved ones. Depending on how long one’s body has been stuck in fight-or-flight mode, the benefits may be glaring, hard to describe, or difficult to spot.
Outside of what’s covered within the PCL 5 PTSD symptom tracker, many of the benefits experienced fall under the category of “calmness” and “peacefulness.”
This comes to life in many forms following treatment:
Having a clear head
Mind being quiet
Time feels slower
Acting less rushed
Over 83 percent of Stella Patients experience lasting relief after one SGB procedure. And, 43 percent of patients schedule two treatments based on the severity of their symptoms.
The Stella Standard of Care was created to meet your needs before, during, and after treatment.
There are patients that do not receive relief after their first treatment or may not receive as much relief as they were hoping for. In rare cases, some may experience an inability to control emotions, increased anxiety or panic attacks, or worsened sleep. If a second treatment, typically on the left side, is not already a part of the care plan, it will be recommended to those who experience these symptoms.
While the majority of people find relief after they receive the second treatment, Stella will work directly with 10-20 percent who did not experience any benefits from SGB and help navigate them on additional treatment options.
The Next 14 – 30 Days
You may not notice changes in your symptoms at first but those close to you might observe changes in your behavior. Ask a trusted family member or friend to take inventory of how you’ve changed and have them share their observations with you. This exercise is eye-opening for many Stella patients. You may need to encounter stressful situations to realize that your response to them is different.
When the body is no longer stuck in fight-or-flight mode, symptoms dissipate, which can positively impact how we move through daily tasks. Many people note that they:
Find driving is less stressful
See more clearly – colors appear brighter and their vision is sharper
Can more easily handle social situations or go out in public
Feel more sociable
Experience less physical pain
Can actively listen and more thoughtfully engage in conversations
Interested in picking up old (or new) hobbies
Are a more confident parent and/or partner
Are excited about future planning
SGB gives people the ability to feel in a way that they did not think was possible.
Read more of Stella’s anonymous reviews in real-time to hear more about how people are experiencing life after treatment.
How Long Does SGB Last?
The lasting impact of SGB varies from individual to individual. In a study where participants were surveyed 3-6 months after treatment, 70 percent still reported a successful outcome. Many people find lasting results for years after treatment.
On average, 8 to 12 percent of Stella patients return for additional SGB treatment. Many have incorporated ongoing SGB treatments into their mental health care plan based on personal lifestyle, stressors, new traumas and/or response to treatment.
While all of the benefits of SGB treatments are still unknown, Stella sees an increasing number of patients reporting after receiving SGB, they have:
Reduced their use of or stopped taking prescription medications
Less PMS (premenstrual syndrome) symptoms
More memories from childhood
Less face and neck flushing
Decreased gag reflex
SGB is not a “cure” for PTSD or emotional trauma symptoms. We believe that the formula for lasting relief is a combination of biological and psychological interventions.
Earlier this year, Stella Provider Dr. Luke D. Liu published a case study explaining how SGB successfully reduced long COVID symptoms. The result of this study led to Stella and RTHM partnering to provide RTHM’s Long COVID patients with access to Stella’s SGB treatment.
A new clinical trial sponsored by NYU Langone Health is leveraging Dr. Lipov’s modified SGB method, the Dual Sympathetic Reset, and Stella’s New York Provider to test SGB’s efficacy on PTSD symptoms through the use of brain scans. Researchers hope will help destigmatize PTSD as an illness and add to the public’s understanding of SGB as a potential treatment.
Primary care and functional medicine practices, like Cornerstone, are now offering SGB to their patients through Stella’s Certified MD network.